Perio Revision Flashcards
Name the important pathogenic bacteria in periodontitis
P. Gingivalis
P. Intermedia
T. Forsythia
T. Denticola
Describe an overactive immune response for periodontitis
Lots of inflammatory mediators which cause long standing inflammation and destruction of tissues
Describe an under active immune response for periodontitis
Host immune reaction is lessened, and therefore the biofilm is allowed to grow and diversify, resulting in destruction of tissues
Give examples of systemic risk factors for periodontitis
(Modifiable and non-modifiable) Age Genetic factors/hereditary Hormonal changes (pregnancy/puberty) Smoking Poorly controlled diabetes Osteoporosis Medications
Give examples of local risk factors of periodontitis
Calculus
Overhanging restorations
What is another common risk factor in periodontitis
Poor dental attendance
Name the different probes used in perio patients
CPITN/BPE Probe PCP 12 Probe UNC Probe William’s Probe Naber’s Probe
Describe a BPE Probe
0.5mm ball point end
Black band from 3.5mm - 5.5mm
Describe a PCP 12 Probe and when it is used
Black bands from 3-6mm and 9-12mm
Used for 6 point pocket charts
Describe a UNC probe
Bands every mm from 1-15
Describe a William’s probe
Black bands from 1-3, 5 and 7-10mm
What is the Naber’s probe used for
Used for measuring furcation areas
Describe a BPE score of 0
Black band of CPITN probe is completely visible No probing depths of >3.5mm No bleeding on probing No plaque retentive factors No need for periodontal treatment
Describe a BPE score of 1
Black band of CPITN probe is still completely visible No probing depths >3.5mm No plaque retentive factors Bleeding on probing Treatment - OHI
Describe a BPE score of 2
Black band of CPITN probe still completely visible
No probing depths of >3.5mm
Plaque retentive factors present
Bleeding on probing
Treatment - OHI, removal of plaque retentive factors including all supra- and sub-gingival calculus
Describe a BPE score of 3
Black band of CPITN probe partially visible
Probing depths of between 3.5mm and 5.5mm
Bleeding can occur
Plaque retentive factors often present
Treatment - OHI, RSD
Describe a BPE score of 4
Black band of CPITN probe no longer visible
Probing depths greater than 6mm
Bleeding can occur
Plaque retentive factors often present
Treatment - OHI, RSD, assess the need for more complex treatment, referral to a specialist may be needed
Describe furcation involvement and how it is treated
Measure of intra-radicular bone loss
Use a Naber’s probe to assess it grade 1-3
Treatment - OHI, RSD, assess the need for more complex treatment, referral to a specialist may be required
What is a 6 point pocket chart
A specialist investigation used to gather more information about the level of periodontal disease the patient has
When should a six point pocket chart be taken
A full mouth 6PPC is any sextant scores a BPE 4/* or if more than one sextant scores a BPE 3
Which surfaces of teeth are examined in a 6PPC
Palatal/lingual:
Mesial
Mid
Distal
Buccal:
Mesial
Mid
Distal
What does a 6PPC measure
Position of gingival margin Probing depths Clinical attachment loss Bleeding on probing Mobility Furcation involvement
What is the position of the gingival margin and how is it measured
Where the gingiva sits in relation to the ACJ
Measured using the PCP12 probe
What are probing depths and how are they measured
The depth of the periodontal pocket being measured
Measure from the base of the pocket to the gingival margin using a PCP12 probe
What is clinical attachment loss
A measure of how much supporting tissue attachment has been lost in relation to periodontal health where there would be little/no attachment loss
How is clinical attachment loss calculated
By adding the position of the gingival margin to the probing depths
What is important to note during the calculation of clinical attachment loss
Sometimes the gingival margin can sit coronal to the ACJ (swelling, hyperplasia etc.)
In this case, the position of the gingival margin is given a negative value
How is tooth mobility measured
With the ends of two rigid instruments eg - mirror and probe, or with one instrument and a finger
Describe a tooth mobility score of 0
‘Physiological’ mobility measured at the crown level
The tooth is mobile within the alveolus to approximately 0.1 - 0.2mm in a horizontal direction
Describe a tooth mobility score of 1
Increased mobility of the crown of the tooth to, at the most, 1mm in a horizontal direction
Describe a tooth mobility score of 2
Visually increased mobility of the crown of the tooth exceeding 1mm in a horizontal direction
Describe a tooth mobility score of 3
Severe mobility of the crown of the tooth in both horizontal and vertical directions, impinging on the function of the tooth
How is furcation involvement measured
In thirds:
Grade 1 = 1/3 of the tooth width
Grade 2 = 2/3 of the tooth width
Grade 3 = 3/3 or 100% of the tooth width
Name the different scalers used in perio patients
Colombia Curette Mini-Sickle Hoe 134-135 Hoe 156-157 Gracey 1-2 Gracey 7-8 Gracey 11-12 Gracey 13-14
Describe a Colombia Curette scaler
Red 2 cutting edges Used for all tooth surfaces Used sub gingivally Semi-circular cross-section
Describe a Mini-Sickle scaler
Red 2 cutting edges Used on buccal and lingual surfaces Used supra-gingivally Triangular cross-section
Describe a Hoe 134-135 scaler
Yellow
Removes gross caries
Used on buccal and lingual surfaces
Used supra- and sub-gingivally
Describe a Hoe 156-157 scaler
Red
Removes gross caries
Used on mesial and distal surfaces
Used supra- and sub-gingivally
Describe a Gracey 1-2 scaler
Grey 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used on anterior teeth Used on all surfaces
Describe a Gracey 7-8 scaler
Green 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used on posterior teeth Used on buccal and lingual surfaces
Describe a Gracey 1-12 scaler
Orange 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used on posterior teeth Used on the mesial surface
Describe a Gracey 13-14 scaler
1 cutting edge Used for fine/deep scaling Used sub-gingivally Used in posterior teeth Used on the distal surface
What is TIPPS
An intervention used to help patient change their behaviour/attitude towards their oral hygiene routine, there are 5 steps
Name and describe the steps of TIPPS
Talk - to the patient about the causes of periodontitis
Instruct - on the best ways to ensure plaque removal
Plan - put into place a plan which specifies how the patient will incorporate the given instructions into their routine
Practice - ask the patient to practice cleaning their teeth in the dental surgery
Support - the patient at subsequent visits
